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What Causes Vomiting, Diarrhea, Poor Appetite And Insomnia In An Elderly Woman?
Question: Hi Dr. XXXXXXX
Few Questions:
1)My mother who is 61 years old had an orthopaedic surgery with plates and screws implanted on 2nd of July 2016.She was discharged on 5th July and brought back home.She was fine for say about ten days and subsequent to which complained of not wanting to eat anything, vomitting ,diarrhoea, and lack of sleep.We used to give her medicine for high blood pressure - Telma H.She could not eat for four - five days and fell unconsicious one night and was admitted in hospital.On investigation all her reports were normal including ECG, Echo, LFT, KFT and all.Doctor said her Sodium and Potassium levels went considerably low .She was on saline and Sodium drips and her sodium level increased to 134.My question is does orthopaedic surgery reduce sodium level in body?
2)Today again her sodium level was measured and it came out to be 131.so why the drop.Does the level fluctuate?
3)Is surgery and Telma H the cause of Hyponatermia - sodium loss.
4)After her discharge how will we monitor her sodium level at home?Is there any device for that or only blood tests will help?
5)Is there any chance of relapse?
6)What are the precautions to be taken at home?
7)Can you suggest any special diet,drinks which will help her maintain sodium level?
8)How common is this problem?
Awaiting your reply.
Regards
Few Questions:
1)My mother who is 61 years old had an orthopaedic surgery with plates and screws implanted on 2nd of July 2016.She was discharged on 5th July and brought back home.She was fine for say about ten days and subsequent to which complained of not wanting to eat anything, vomitting ,diarrhoea, and lack of sleep.We used to give her medicine for high blood pressure - Telma H.She could not eat for four - five days and fell unconsicious one night and was admitted in hospital.On investigation all her reports were normal including ECG, Echo, LFT, KFT and all.Doctor said her Sodium and Potassium levels went considerably low .She was on saline and Sodium drips and her sodium level increased to 134.My question is does orthopaedic surgery reduce sodium level in body?
2)Today again her sodium level was measured and it came out to be 131.so why the drop.Does the level fluctuate?
3)Is surgery and Telma H the cause of Hyponatermia - sodium loss.
4)After her discharge how will we monitor her sodium level at home?Is there any device for that or only blood tests will help?
5)Is there any chance of relapse?
6)What are the precautions to be taken at home?
7)Can you suggest any special diet,drinks which will help her maintain sodium level?
8)How common is this problem?
Awaiting your reply.
Regards
Brief Answer:
Her symptoms can be explained by low sodium.
Detailed Answer:
1. Surgeries either orthopaedic or otherwise can cause SIADH, that can lead to low sodium. Telma-H contains hydrochlothiazide which contributes to increased sodium loss in urine. Both these effects are more pronounced in the elderly.
2. Duration of SIADH is variable, usually won't be more than a couple of weeks.and unlikely to recur.
3. Stopping Telma -H, avoiding excessive fluid intake, and keeping normal salt intake would help.
4. No other method than to check blood for serum sodium. At least twice weekly.
5. If sodium levels persistently remain low, you doctor may add a medicine Tolvaptan.
6. Thyroid function to be checked as may contribute to low sodium.
7. Milder forms of low sodium are common in these settings....
warm regards
Her symptoms can be explained by low sodium.
Detailed Answer:
1. Surgeries either orthopaedic or otherwise can cause SIADH, that can lead to low sodium. Telma-H contains hydrochlothiazide which contributes to increased sodium loss in urine. Both these effects are more pronounced in the elderly.
2. Duration of SIADH is variable, usually won't be more than a couple of weeks.and unlikely to recur.
3. Stopping Telma -H, avoiding excessive fluid intake, and keeping normal salt intake would help.
4. No other method than to check blood for serum sodium. At least twice weekly.
5. If sodium levels persistently remain low, you doctor may add a medicine Tolvaptan.
6. Thyroid function to be checked as may contribute to low sodium.
7. Milder forms of low sodium are common in these settings....
warm regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks for your reply Dr.
Does sodium level fluctuate as in her case it had reached to 134 and then again dropped to 131.What is da reason of this fluctuation
?
How common is this problem?
Which thyroid should we get tested- Tsh,T4 or t3.
Can you suggest some good drinks which will help maintain her sodium, potassium level
Does sodium level fluctuate as in her case it had reached to 134 and then again dropped to 131.What is da reason of this fluctuation
?
How common is this problem?
Which thyroid should we get tested- Tsh,T4 or t3.
Can you suggest some good drinks which will help maintain her sodium, potassium level
Brief Answer:
Mild fluctuations are normal and also found in normal persons.
Detailed Answer:
Hyponatremia <125 is usually significant. Above this especially > 130 doesn't need specific intervention.
T3, T4, TSH : all three should be done the first time...
No specific drinks to maintain Sodium . however limiting fluid intake <1000-1200ml a day should help.
Juices and coconut water would help increase potassium.
Mild fluctuations are normal and also found in normal persons.
Detailed Answer:
Hyponatremia <125 is usually significant. Above this especially > 130 doesn't need specific intervention.
T3, T4, TSH : all three should be done the first time...
No specific drinks to maintain Sodium . however limiting fluid intake <1000-1200ml a day should help.
Juices and coconut water would help increase potassium.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr XXXXXXX
We have been monitoring her Sodium and Potassium levels through blood test and yesterday it came out to be 135 and today 134.Hope the range is normal.
Also we monitor her bp through home kit and it came out to be 155-80.so doctor told us to give us Cresar 40 ie Telma.What is da diff bet TelmaH and Creasr 40 as all her salt got depleted due to Telma H.
Till how long we need to monitor her na and k levrl
We have been monitoring her Sodium and Potassium levels through blood test and yesterday it came out to be 135 and today 134.Hope the range is normal.
Also we monitor her bp through home kit and it came out to be 155-80.so doctor told us to give us Cresar 40 ie Telma.What is da diff bet TelmaH and Creasr 40 as all her salt got depleted due to Telma H.
Till how long we need to monitor her na and k levrl
Brief Answer:
Yes her sodium levles are acceptable.
Detailed Answer:
Telma H contains Hydrochlorthiazide and can cause low sodium,
Check after 15 days and then after a month if normal
Regards
Yes her sodium levles are acceptable.
Detailed Answer:
Telma H contains Hydrochlorthiazide and can cause low sodium,
Check after 15 days and then after a month if normal
Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Sonia Raina
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